CHARLES JOSEPH DIETZEN MD - Medical Doctor License in Indiana | # 036092707

CHARLES JOSEPH DIETZEN MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092707

License Status

INACTIVE

Business

N

First Name

CHARLES JOSEPH

Last Name

DIETZEN

Suffix

MD

Business Name

CHARLES JOSEPH DIETZEN MD

Original Issue Date

05/21/1996

Effective Date

05/21/1996

Expiration Date

07/31/1999

State

IN

Ever Disciplined

N

LastModifiedDate

09/20/2006